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Purpose To suggest a novel classification of neovascular age-related macular degeneration ( AMD) based on optical coherence tomography angiography ( OCTA) and to correlate morphological characteristics based on optical coherence tomography (OCT)/ OCTA with clinical criteria of disease activity. Methods A total of 88 eyes with neovascular AMD (14 treatment-naïve, 74 eyes following anti-vascular endothelial growth factor treatment (VEGF)) were examined using the AngioVue OCTA system (Optovue, Inc., Fremont, CA, USA) and evaluated based on vascular morphology. Choroidal neovascularization ( CNV)-vessel morphology based on OCTA and associations with retinal layers were described and correlated with clinical markers of disease activity. Results In treatment-naïve CNV, CNV-vessel morphology based on OCTA showed a dense-net configuration ( DN) in 12 of 14 eyes, a loose-net configuration ( LN) in one of 14 eyes and an unidentifiable CNV pattern in one of 14 eyes, whereas in treated CNV, DN was registered in 43.2% (32/74), LN in 27% (20/74), DN with additional LN (mixed type) in 14.9% (11/74) and an unidentifiable CNV pattern in 14.9% (11/74). Clinical correlations revealed a significantly longer disease duration for LN with a median value of 4.3 years compared to DN with 2.0 years (p = 0.009) and for CNV involving the outer retina with 3.1 years compared to CNV not involving the outer retina with 1.9 years (p = 0.051). Conclusion Optical coherence tomography angiography (OCTA) allows identification of distinct CNV-specific vascular patterns at the level of the outer retinal layer and choriocapillaris. Correlation with clinical and functional parameters may be useful to better understand pathophysiological mechanisms and guide efficient therapeutic strategies. [ABSTRACT FROM AUTHOR]

Aim: To identify influence of orthostasis and daytime on retinal-thickness in cystoid-macular-edema (CME) using SD-OCT. Methods: In this cross-sectional study 18 eyes with uveitis-associated CME (uvCME) were included. Orthostatic-changes of retinal-thickness were analyzed using a Cirrus™ SD-OCT. Retinal-thickness was measured with patients lying horizontally on their side, followed by a fast sitting-up and OCT-measurement in sitting-position. Diurnal-change in thicknesses were assessed by Spectralis™ OCT between 8 AM and 8 PM. Results: Approximately 20 s elapsed between position-change and the following OCT-measurement. In horizontal-position, the mean central retinal thickness (CRT) was 496 ± 37 µm, in upright position, the mean CRT was reduced to 412 ± 43 µm ( p = 0.032), thus position-change led to a 17% decrease in CRT. None of the other ETDRS-subfields showed a statistically significant decrease in thicknesses ( p > 0.05). In the second experiment, diurnal-CRT decreased over time, whereas the main decrease happened in the morning (8 a.m. 559 ± 35 µm, 12 p.m. 533 ± 36 µm, 4 p.m. 538 ± 32 µm, 8 p.m.551 ± 38 µm, p = 0.01). Thicknesses in all other ETDRS-subgrids did not decrease statistically significantly. Conclusions: Intraretinal-fluid in uvCME may show a high mobility: CRT decreases within seconds after a patient changes position, indicating that position effects retinal-thickness. Main diurnal-decrease in CRT occurs before noon, which is likely due to a position-change in the morning. Patient-population (walk-in patients versus hospitalized, lying patients) and previous waiting-position should be considered when interpreting retinal-thickness in clinical-practice. [ABSTRACT FROM AUTHOR]

Purpose: To relate the functional response to distinct morphological features of the retina during aflibercept treatment for neovascular AMD (nAMD)., Methods: A total of 726 retinal locations in 22 consecutive eyes presenting with treatment-naive nAMD underwent a standardized examination with spectral-domain optical coherence tomography (SD-OCT) and topographic microperimetry (MP) at baseline, after 3 and 12 months of continuous intravitreal aflibercept therapy. The retinal sensitivity at each stimulus location was registered to the corresponding location on SD-OCT morphology. Subsequently, the microperimetric responses were evaluated with respect to the following underlying SD-OCT features: neovascular complex (NVC), subretinal fluid (SRF), intraretinal fluid (IRF), intraretinal cystoid space (IRC), serous pigment epithelium detachment (sPED), and fibrovascular pigment epithelium detachment (fPED)., Results: Baseline sensitivity was reduced to mean values of 1.8 dB in NVC, 2.2 dB in IRC, 2.8 dB in IRF, 2.6 dB in sPED, 3.6 dB in SRF, and 4.6 dB in fPED. Improvements in retinal sensitivity were most pronounced during the initial 3-month interval, when significant recovery was documented for SRF and sPED with +4.0/5.5 dB (P < 0.0001) and to a lesser extent for IRF, IRC, fPED, with +1.1, 1.7, 2.3 dB, respectively. From month 3 to 12, the additional benefit ranged from 0.3 to 1.0 dB (P > 0.05 for each category)., Conclusions: Significant functional benefits following intravitreal aflibercept treatment could be detected over all defined morphological pathologies. The level of improvement varied dependent on the associated feature with the best prognosis for visual improvement in SRF and sPED and least with intraretinal fluid and particularly intraretinal cysts., (Copyright 2015 The Association for Research in Vision and Ophthalmology, Inc.)